The GAHR score for prediction of in-hospital mortality patients with aneurysmal subarachnoid hemorrhage

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-06-28 DOI:10.1016/j.jocn.2025.111438

Beny Rilianto , Bambang Tri Prasetyo , Ricky Gusanto Kurniawan , Nurfadilah M. Rajab , Sardiana Salam , Ita Muharram Sari , Muhammad Kusdiansah , Abrar Arham , Eka Musridharta , Mursyid Bustami

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引用次数: 0

Abstract

Background

Aneurysmal subarachnoid hemorrhage (aSAH) remains a prominent cause of mortality. There are several factors associated with the overall outcome. This study aimed to develop a simple scoring model of the 30-day mortality in aSAH.

Methods

We retrospectively analyzed the total number of aSAH patients hospitalized at the advanced stroke center between January 2019 and June 2022. Multivariable logistic regression generated the odds ratio of age- and sex-adjusted mortality for aSAH. Scoring predictors were derived from regression β-coefficients and converted into a point score system. The diagnostic performance and probability of in-hospital mortality were assessed.

Results

We included 318 aSAH patients, and 61 (19.18%) patients died during hospitalization. The aSAH mortality prediction (GAHR) score with a range of 0–12 points was assigned the following point values: grade of aSAH (4 points), aneurysmal treatment (3 points), heart comorbidities (2 points), and respiratory failure (3 points). The GAHR score displayed an area under the receiving operating characteristics curve (AUC) of 0.8294 (SE 0.0277) and a p-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.4133. The probability of in-hospital mortality was assessed based on the total score of each patient.

Conclusions

The GAHR score is a simple, convenient, and reliable scoring system with four clinical predictors containing grade, aneurysmal treatment, heart comorbidities, and respiratory failure to predict in-hospital mortality of aSAH. This scoring system has good accuracy and may aid clinicians in decision-making and determining the prognosis of patients.

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GAHR评分预测动脉瘤性蛛网膜下腔出血患者的住院死亡率

背景：动脉瘤性蛛网膜下腔出血（aSAH）仍然是一个重要的死亡原因。有几个因素与总体结果有关。本研究旨在建立aSAH患者30天死亡率的简单评分模型。方法回顾性分析2019年1月至2022年6月在晚期脑卒中中心住院的aSAH患者总数。多变量逻辑回归产生了aSAH的年龄和性别调整死亡率的优势比。评分预测因子由回归β系数导出，并转化为积分评分系统。评估诊断效能和住院死亡率。结果纳入318例aSAH患者，其中61例（19.18%）在住院期间死亡。aSAH死亡率预测（GAHR）评分范围为0-12分，分值为：aSAH分级（4分）、动脉瘤治疗（3分）、心脏合并症（2分）和呼吸衰竭（3分）。GAHR评分显示接收工作特征曲线下面积（AUC）为0.8294 (SE 0.0277), Hosmer-Lemeshow （HL）拟合优度的p值为0.4133。根据每位患者的总得分评估住院死亡率的概率。结论GAHR评分是一种简单、方便、可靠的评分系统，包含分级、动脉瘤治疗、心脏合并症和呼吸衰竭4个临床预测指标，可预测aSAH的住院死亡率。该评分系统具有良好的准确性，可以帮助临床医生决策和确定患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.